Requirements Prior To Trauma Processing in EMDR Therapy
Updated: Sep 29, 2019
EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapeutic method - tool that is based on the principle of bilateral stimulation –originally right-left eye movements– and aims in processing traumatic and distressing memories.
EMDR is a promising and highly effective treatment method of traumas, that gradually gains increased popularity due to its fast efficacy and positive treatment outcomes.
If you are interested in finding out more about what EMDR is, you can read about it here.
You may wonder, just how much information is required to provide your therapist about yourself, before actually starting trauma work?
Any psychologist can probably claim that, the more information we can get from a client, the better we get to understand them and their needs.
I most often do EMDR with clients that have worked with me already for some time, because this guarantees the presence of a stable and trusting therapeutic relationship with them.
If someone comes to me primarily for treating trauma, then there’s a lot that needs to happen before we’re ready to process trauma through our work together. I will briefly explain about the different therapy phases of EMDR, in order to highlight my point better.
EMDR consists of 8 therapeutic phases:
1. Client History and Treatment Planning
EMDR Processing Session
4. Desensitization and Reprocessing
6. Body Scan
The Preparation and Stabilization phase are the most crucial for the whole EMDR therapy to go well.
Like with any other type of psychotherapy, a detailed history of the client needs to be obtained. Only this time, this is focused on traumas, so we’re talking about trauma history, not just history of the presenting complaint or reason to seek therapy.
We examine the history both before and after the trauma, but generally avoid going into too many details with regards to the trauma itself, because that may start processing work within the client- and it is best to ensure that they are well-prepared and resilient enough in order to do so. Of course that is the starting point, but from then on we move towards understanding the life history of that person as a whole.
The goals here are:
to assess the structure of their personality
to explore the healthy and resilient parts of themselves - the “skills and resources” of the person
to understand their motives for wanting to get better, as well as their motives for staying where they are (= the secondary gain)
to evaluate their symptoms and their severity
to realize their patterns in behaviour (both functional and dysfunctional)
to establish the most prominent underlying negative beliefs about the Self through their life history, as well as the negative emotions that seem to distress them the most
to understand what are the “triggers” of the client; what are their "hot spots" that set them off, what kind of “themes” or interactions are most difficult for them to manage
An important aspect to evaluate is whether the client experiences dissociation, and to what extend- as well as realize the different Parts that may exist in themselves.
Often -but not necessarily- this history-taking may result in a diagnosis, thus we also check for possible commorbidity.
After obtaining this rather broad history, the therapist is able to create a therapeutic treatment plan for the client.
What other steps, besides History, are needed prior to trauma processing?
The next step is Stabilization and Resourcing (developing adequate resources) for the client to later be able to process trauma. The importance of this phase is underlined, by reviewing its goals and objectives.
Establishing Objective Safety in the Present: A stable therapeutic relationship that is characterized by Trust in necessary prior to starting trauma work, as well as ensuring that the client is not currently in a traumatic or dangerous state . For example, if a client has been physically abused by their husband, it is not recommended start trauma work unless they are safe; away from their abuser, stronger and more resilient. While they remain in a traumatic environment , it is actually counter-productive and dangerous to start processing traumatic content as it can cause re-traumatization within the therapy context.
Achieving Mental, Emotional and Psychological Balance and Stability prior to Trauma Processing: During the Stabilization Phase, you will be trained in various relaxation and grounding exercises, as well as guided to develop emotional regulation techniques that work best for you, and distancing and stress-management techniques so that you will not be overwhelmed when processing trauma. Moreover, you will gain knowledge about how trauma affects you by psychoeducation etc.
In other words, You First Need to Be Empowered, Resilient and Stabilized in order to start processing trauma.
The exact duration of the 1st and 2nd EMDR phases (History & Stabilization , respectively) is a bit arbitrary, which means it depends on the each different client, the trauma they are there to process (the more severe or intense the trauma, the longer the Stabilization Phase should be, so that the person can become as resilient and stabilized as possible prior to trauma work) , and the approach, experience and school of thought of the therapist.
Thus, this can greatly vary. While the actual history could be completed in 2-3 sessions, the stabilization phase could take much longer than that.
According to many EMDR specialists, this stabilization phase is the most important of all phases- for some , it could be even a few months before trauma processing can start.
What I can guarantee though, is that with a caring and sensitive therapist, the whole journey of EMDR will be worthwhile- there’s just so much about Yourself that you will learn, and the sense of Empowerment is invaluable!
Read more about the 8 Phases of EMDR :
Shapiro, F. (1997). 8 Phases of EMDR. http://www.behavior.net/forums/evolutionary/1998/7-user=&email=&depth=8&detail=description&lastread=5-29.htm